Form of the International Ship Security Certificate

INTERNATIONAL SHIP SECURITY CERTIFICATE

Certificate No

Issued under the provisions of the

INTERNATIONAL CODE FOR THE SECURITY OF SHIPS AND OF PORT FACILITIES

(ISPS CODE)

Under the authority of the GOVERNMENT OF THE REPUBLIC OF FIJI by the Maritime Safety

Authority of Fiji

Name of ship: .................................................................................

Distinctive number or letters: .................................................................................

Port of registry: .................................................................................

Type of ship: .................................................................................

Gross tonnage: .................................................................................

IMO Number: .................................................................................

Name and address of the Company: .................................................................................

THIS IS TO CERTIFY—

1.0 That the security system and any associated security equipment of the ship has been verified in accordance with section 19.1 of Part A of the ISPS Code;

2.0 That the verification showed that the security system and any associated security equipment of the ship is in all respects satisfactory and that the ship complies with the applicable requirements of Chapter XI-2 of the SOLAS Convention and Part A of the ISPS Code;

3.0 That the ship is provided with an approved Ship Security Plan.

Date of initial/renewal verification on which this certificate is based: .................................................................................

This Certificate is valid until ................................................................................. subject to verifications in accordance with section 19.1.1 of Part A of the ISPS Code.

Issued at.................................. Date of issue: .................................................................................

(Place of issue of the Certificate)

................................................................

(*Signature of the duly authorised official issuing the Certificate)

(*Seal or stamp of issuing authority, as appropriate, must be affixed)

ENDORSEMENT FOR INTERMEDIATE VERIFICATION

THIS IS TO CERTIFY that at an intermediate verification required by section 19.1.1 of Part A of the ISPS Code, the ship was found to comply with the relevant provisions of Chapter XI-2 of the SOLAS Convention and Part A of the ISPS Code.

(*Seal or stamp of issuing authority, as appropriate, must be affixed)

ENDORSEMENT FOR ADDITIONAL VERIFICATIONS**

(**This part of the certificate shall be adapted by the Authority to indicate whether it has established additional verifications as provided for in section 19.1.1.4 of Part A of the ISPS Code)

(*Seal or stamp of issuing authority, as appropriate, must be affixed)

ADDITIONAL VERIFICATION IN ACCORDANCE WITH SECTION A/19.3.7.2 OF THE ISPS CODE

THIS IS TO CERTIFY that at an additional verification required by section 19.3.7.2 of Part A of the ISPS Code, the ship was found to comply with the relevant provisions of Chapter XI-2 of the SOLAS Convention and Part A of the ISPS Code.

(*Seal or stamp of issuing authority, as appropriate, must be affixed)

ENDORSEMENT TO EXTEND THE CERTIFICATE IF VALID FOR LESS THAN 5 YEARS WHERE SECTION A/19.3.3 OF THE ISPS CODE APPLIES

The ship complies with the relevant provisions of Part A of the ISPS Code, and the Certificate shall, in accordance with section 19.3.3 of Part A of the ISPS Code, be accepted as valid until ................................................................

(*Seal or stamp of issuing authority, as appropriate, must be affixed)

ENDORSEMENT WHERE THE RENEWAL VERIFICATION HAS BEEN COMPLETED AND SECTION A/19.3.4 OF THE ISPS CODE APPLIES

The ship complies with the relevant provisions of Part A of the ISPS Code, and the Certificate shall, in accordance with section 19.3.4 of Part A of the ISPS Code, be accepted as valid until ................................................................

(*Seal or stamp of issuing authority, as appropriate, must be affixed)

ENDORSEMENT TO EXTEND THE VALIDITY OF THE CERTIFICATE UNTIL REACHING THE PORT OF VERIFICATION WHERE SECTION A/19.3.5 OF THE ISPS CODE APPLIES OR FOR A PERIOD OF GRACE WHERE SECTION A/19.3.6 OF THE ISPS CODE APPLIES

This Certificate shall, in accordance with section 19.3.5 / 19.3.6 (delete where appropriate) of Part A of the ISPS Code, be accepted as valid until ................................................................

(*Seal or stamp of issuing authority, as appropriate, must be affixed)

ENDORSEMENT FOR ADVANCEMENT OF EXPIRY DATE WHERE SECTION A/19.3.7.1 OF THE ISPS CODE APPLIES

In accordance with section 19.3.7.1 of Part A of the ISPS Code, the new expiry date** is ................................................................

(**In case of completion of this part of the certificate, the expiry date shown on the front of the Certificate shall also be amended accordingly)

(*Seal or stamp of issuing authority, as appropriate, must be affixed)